This version of the form is not currently in use and is provided for reference only. Download this version of Form SSA-5665-bk for the current year.
This is a legal form that was released by the U.S. Social Security Administration on June 1, 2018 and used country-wide. As of today, no separate filing guidelines for the form are provided by the issuing department.
Q: What is Form SSA-5665-bk?
A: Form SSA-5665-bk is a Teacher Questionnaire used by the Social Security Administration (SSA).
Q: Who uses Form SSA-5665-bk?
A: The SSA uses Form SSA-5665-bk to gather information from teachers to help determine eligibility for disability benefits.
Q: What information is required on Form SSA-5665-bk?
A: Form SSA-5665-bk asks for details about the teacher's education, work history, medical conditions, and the impact of those conditions on their ability to work.
Q: Do I have to fill out Form SSA-5665-bk?
A: If you are a teacher and are applying for disability benefits, the SSA requires you to complete Form SSA-5665-bk.
Q: Can someone else fill out Form SSA-5665-bk on my behalf?
A: Yes, someone can fill out Form SSA-5665-bk on your behalf, but it is important that they have accurate and complete information about your education, work history, and medical conditions.
Q: What should I do if I need help filling out Form SSA-5665-bk?
A: If you need assistance with Form SSA-5665-bk, you can contact the SSA or seek help from a professional, such as a disability attorney or advocate.
Form Details:
Download a fillable version of Form SSA-5665-bk by clicking the link below or browse more documents and templates provided by the U.S. Social Security Administration.